Formulations of human tissue kallikrein-1 for parenteral delivery and related methods

ABSTRACT

Provided are high concentration compositions of tissue kallikrein-1 (KLK1) and methods of parenterally administering such compositions to a subject in need thereof, where absorption into the circulation via, for example, intravenous or subcutaneous administration improves systemic pharmacokinetics, bioavailability, safety, and/or convenience relative to intravenous or other forms of administration. Also provided are recombinant human KLK1 (rhKLK1) polypeptides that can be readily concentrated to high protein concentrations, and substantially pure compositions thereof.

CONTINUING APPLICATION DATA

This application is a continuation of U.S. patent application Ser. No.14/736,483, filed Jun. 11, 2015; which is a continuation application ofabandoned U.S. patent application Ser. No. 13/901,715, filed on May 24,2013; which claims the benefit of U.S. Provisional Application Ser. No.61/791,762, filed Mar. 15, 2013, and U.S. Provisional Application Ser.No. 61/652,069, filed May 25, 2012; each of which is incorporated byreference herein.

STATEMENT REGARDING SEQUENCE LISTING

The Sequence Listing associated with this application is provided intext format in lieu of a paper copy, and is hereby incorporated byreference into the specification. The name of the text file containingthe Sequence Listing is DIAM_030_04US_ST25. The text file is about 6 KB,was created on Mar. 1, 2017, and is being submitted electronically viaEFS-Web.

BACKGROUND

In healthy individuals, insulin release by the pancreas is strictlycoupled to the blood glucose concentration. Elevated blood glucoselevels like those occurring after meals are rapidly compensated by acorresponding rise in insulin secretion. Diabetes mellitus, or simplydiabetes, is a group of metabolic diseases in which a person has highblood sugar, either because the pancreas does not produce enoughinsulin, or because cells do not respond to the insulin that isproduced. Around 366 million people worldwide suffer from diabetesmellitus. Untreated, diabetes can cause many complications. Acutecomplications include diabetic ketoacidosis and nonketotic hyperosmolarcoma. Serious long-term complications include cardiovascular disease,chronic renal failure, diabetic retinopathy, and diabetic neuropathy.The adequate treatment of diabetes is thus important and there is a needfor improved therapies for the treatment of diabetes. Furthermore, thereis an ongoing need for efficient and safe formulations for theadministration of therapies for the treatment of diabetes.

SUMMARY OF THE INVENTION

The present invention includes a composition formulated for parenteraladministration, the composition having a human tissue kallikrein-1(hKLK1) polypeptide and a pharmaceutically acceptable carrier, whereinthe concentration of the hKLK1 polypeptide in the composition is greaterthan about 5 mg/mL. In some embodiments, the hKLK1 polypeptide has a pIof less than about 5 and a sialic acid content of at least about 4 molesper mole protein. In some embodiments, the hKLK1 concentration isgreater than about 10 mg/mL. In some embodiments, the hKLK1concentration is greater than about 25 mg/mL. In some embodiments, thecomposition is substantially free of aggregates (greater than about 95%appearing as a single peak by SEC HPLC). In some embodiments, thecomposition has endotoxin levels of less than about 1 EU/mg protein,host cell protein of less than about 100 ng/mg protein, host cell DNA ofless than about 10 pg/mg protein. In some embodiments, the hKLK1 has anamino acid sequence with at least about 95% sequence identity toresidues 25-262 of SEQ ID NO:1 or SEQ ID NO:2 and has serine proteaseactivity. In some embodiments, the serine protease activity ischaracterized by the ability to release kallidin from a higher molecularweight precursor. In some embodiments, the hKLK1 polypeptide includesE145 and/or A188, relative to SEQ ID NO:1. In some embodiments, thehKLK1 polypeptide includes Q145 and/or V188, relative to SEQ ID NO:1. Insome embodiments, the hKLK1 polypeptide includes residues 25-262 of SEQID NO:2.

The present invention includes a method of treating a subject in needthereof, the method including parenterally administering to the subjecta composition as described above and thereby treating the subject. Insome embodiments, the composition is administered subcutaenously. Insome embodiments, the composition is administered intravenously.

In some embodiments, administering the composition subcutaneouslyproduces improved systemic pharmacokinetics relative to intravenouslyadministration of the composition. In some embodiments, the improvedpharmacokinetics comprises increased bioavailability. In someembodiments, the improved pharmacokinetics comprises increased Tmax fora subcutaneous injection compared to intravenous injection. In someembodiments, the improved pharmacokinetics comprises decreased Cmax fora subcutaneous injection compared to intravenous injection. In someembodiments, the improved pharmacokinetics comprises increased half-lifeof t½. In some embodiments, the improved pharmacokinetics comprisesincreased absorption rate.

In some embodiments, the subject has established type 1 diabetes (T1D)or type 2 diabetes (T2D). In some embodiments, the subject is in thehoneymoon phase of T1D and has about 10-20% of their pancreatic betacells relative to a healthy control, and produces insulin.

In some embodiments of the method, the method further includesadministering a diabetes drug.

The present invention includes a device including a composition asdescribed above, wherein the device is suitable for parenteral deliveryof the composition. In some embodiments, the device is a syringe. Insome embodiments, the device further includes a hypodermic needleassembly attached to the syringe. In some embodiments, the syringefurther includes a protective cover around the needle assembly. In someembodiments, the needle is about ½ inch to about ⅝ of an inch in lengthand has a gauge of about 25 to about 31.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by those of ordinary skillin the art to which the invention belongs. Although any methods andmaterials similar or equivalent to those described herein can be used inthe practice or testing of the present invention, preferred methods andmaterials are described. For the purposes of the present invention, thefollowing terms are defined below.

The articles “a” and “an” are used herein to refer to one or to morethan one (i.e., to at least one) of the grammatical object of thearticle. By way of example, “an element” means one element or more thanone element.

By “about” is meant a quantity, level, value, number, frequency,percentage, dimension, size, amount, weight or length that varies by asmuch as 30, 25, 20, 15, 10, 9, 8, 7, 6, 5, 4, 3, 2 or 1% to a referencequantity, level, value, number, frequency, percentage, dimension, size,amount, weight or length.

Throughout this specification, unless the context requires otherwise,the words “comprise,” “comprises,” and “comprising” will be understoodto imply the inclusion of a stated step or element or group of steps orelements but not the exclusion of any other step or element or group ofsteps or elements. By “consisting of” is meant including, and limitedto, whatever follows the phrase “consisting of.” Thus, the phrase“consisting of” indicates that the listed elements are required ormandatory, and that no other elements may be present. By “consistingessentially of” is meant including any elements listed after the phrase,and limited to other elements that do not interfere with or contributeto the activity or action specified in the disclosure for the listedelements. Thus, the phrase “consisting essentially of” indicates thatthe listed elements are required or mandatory, but that other elementsare optional and may or may not be present depending upon whether or notthey materially affect the activity or action of the listed elements.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an SDS-PAGE gel stained with Coomassie Blue stain of variousamounts of recombinant human KLK1 purified from CHO or 293 cell linesfollowing transient transfection. Lane 1 is a pre-stained proteinladder, the molecular weights of the standards are written on the side(in kDa). Lanes 2-5 have KLK1 purified from CHO cells (lane 2, 14 μgprotein; lane 3, 7 μg protein; lane 4, 3.5 μg protein; lane 5, 1.35 μgprotein). Lane 6 has 14 μl of KLK1 protein purified from transienttransfection of 293 cells. Lanes 7-9 are empty.

FIG. 2 is a Western blot stained with mouse anti-human KLK1 polyclonalantibodies of various amounts of recombinant human KLK1 purified fromCHO or 293 cell lines following transient transfection. Lanes 1 and 6are loaded with a pre-stained protein ladder, the molecular weights ofthe standards are written on the side (in kDa). Lanes 2-5 have KLK1purified from CHO cells (lane 2, 5 μl protein; lane 3, 2.5 μl protein;lane 4, 1.25 μl protein). Lane 5 has 2.5 μl of KLK1 protein purifiedfrom transient transfection of 293 cells.

FIGS. 3A and 3B show capillary isoelectric focusing (cIEF) tracing ofrhKLK1 samples determining the pI values among the various glycoforms,indicative of varying amounts of sialic acid. Markers are included witha pI of 3.21 and pI 5.12.

FIGS. 4A and 4B show a SEC HPLC analysis of rhKLK1 formulations at 5mg/mL, 10 mg/mL, 25 mg/mL and 50 mg/mL after storage at 2-8° C. for 7days.

FIGS. 5A and 5B show the mean pharmacokinetic profiles of rhKLK1 in maleSprague-Dawley rat plasma following subcutaneous (5A) or intravenous(5B) bolus injection of rhKLK1.

FIG. 6 shows the mean pharmacokinetic profiles of rhKLK1 in male andfemale Sprague-Dawley rat plasma following subcutaneous bolus injectionof rhKLK1 at a dose of about 3.69 mg/kg.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides compositions of tissue kallikrein-1(KLK1) that allow for improved absorption with parenteraladministration. Such compositions are high concentration, liquidformulations of KLK1, at concentrations of up to about 100 mg/mL. Suchhigh concentration formulations may advantageously be administered in asmaller volume injection. Also included are methods for the parenteraladministration of such formulations to a subject in need thereof, wheresuch administration has been surprisingly shown to improve thepharmacokinetic (PK) and pharmacodynamic (PD) parameters of KLK1bioavailability.

Tissue kallikreins are members of a gene super family of serineproteases comprising at least 15 separate and distinct proteins (namedtissue kallikrein 1 through 15) (Yousef et al., 2001, Endocrine Rev;22:184-204). Tissue kallikrein-1 is produced predominantly in thepancreas, hence the origin of the name from the Greek term ‘kallikrein.’It is also produced in the salivary glands and kidneys and is found inthe urogenital tract and in skeletal muscle. Tissue kallikrein-1 is alsoknown as KLK1, pancreatic/renal kallikrein, glandular kallikrein 1,kallikrein serine protease 1, kallikrein 1, renal kallikrein,renal/pancreas/salivary kallikrein, kidney/pancreas/salivary glandkallikrein. As used herein, the term “tissue kallikrein-1” and “KLK1”are synonymous.

Tissue kallikrein-1 is a trypsin-like serine protease. In humans andanimal tissues, tissue kallikrein-1 cleaves kininogen intolysyl-bradykinin (also known as kallidin), a decapeptide kinin havingphysiologic effects similar to those of bradykinin. Bradykinin is apeptide that causes blood vessels to dilate and therefore causes bloodpressure to lower. Kallidin is identical to bradykinin with anadditional lysine residue added at the N-terminal end and signalsthrough the bradykinin receptor.

The KLK1 gene encodes a single pre-pro-enzyme that is 262 amino acidresidues in length and that includes the “pre-” sequence (residues 1-18)and the “pro-” sequence (residues 19-24), which is activated bytrypsin-like enzymes. The mature and active form human KLK1 is aglycoprotein of 238 amino acid residues (residues 25-262) with amolecular weight of 26 kDa and a theoretical pI of 4.6. KLK1 has fivedisulphide bonds in its tertiary structure that are believed to beresponsible for the protein's high stability, both against trypsindigestion and heat inactivation.

The amino acid sequence of tissue kallikrein-1 is available for a widevariety of species, including, but not limited to, human (SEQ ID NO:1and SEQ ID NO:2), mouse (see, for example, GenBank: AAA39349.1, Feb. 1,1994); domestic cat (see, for example, NCBI Reference Sequence:XP_003997527.1, Nov. 6, 2012); gorilla (see, for example, NCBI ReferenceSequence: XP_004061305.1, Dec. 3, 2012); cattle (see, for example,GenBank: AAI51559.1, Aug. 2, 2007); dog (see, for example, CBI ReferenceSequence: NP_001003262.1, Feb. 22, 2013); rat (see, for example,GenBank: CAE51906.1, Apr. 25, 2006); and olive baboon (see, for example,NCBI Reference Sequence: XP_003916022.1, Sep. 4, 2012). KLK1 isfunctionally conserved across species in its capacity to release thevasoactive peptide, Lys-bradykinin, from low molecular weight kininogen.A tissue kallikrein-1 polypeptide of the present invention may have anyof the known amino acid sequences for KLK1, or a fragment or variantthereof.

In some aspects, a tissue kallikrein-1 polypeptide is a human tissuekallikrein-1 (hKLK1), including, but not limited to, a hKLK1 polypeptiderepresented by SEQ ID NO:1 or SEQ ID NO:2.

For example, hKLK1 may be represented by the amino acid sequence ofGenBank Ref. NP_002248.1, having the complete KLK1 preproprotein aminoacid sequence shown below:

(SEQ ID NO: 1) MWFLVLCLALSLGGTGAAPPIQSRIVGGWECEQHSQPWQAALYHFSTFQC  50GGILVHRQWVLTAAHCISDNYQLWLGRHNLFDDENTAQFVHVSESFPHPG 100FNMSLLENHTRQADEDYSHDLMLLRLTEPADTITDAVKVVELPTEEPEVG 150STCLASGWGSIEPENFSFPDDLQCVDLKILPNDECKKAHVQKVTDFMLCV 200GHLEGGKDTCVGDSGGPLMCDGVLQGVTSWGYVPCGTPNKPSVAVRVLSY 250 VKWIEDTIAENSAmino acids 1 to 18 of SEQ ID NO:1 represent the signal peptide, aminoacids 19 to 24 represent propeptide sequences, and amino acids 25 to 262represent the mature peptide. Thus, the preproprotien includes apresumptive 17-amino acid signal peptide, a 7-amino acid proenzymefragment and a 238-amino acid mature KLK1 protein.

As described in Example 1, a second amino acid sequence for human KLK1is represented by SEQ ID NO:2, shown below:

(SEQ ID NO: 2) MWFLVLCLALSLGGTGAAPPIQSRIVGGWECEQHSQPWQAALYHFSTFQC  50GGILVHRQWVLTAAHCISDNYQLWLGRHNLFDDENTAQFVHVSESFPHPG 100FNMSLLENHTRQADEDYSHDLMLLRLTEPADTITDAVKVVELPTQEPEVG 150STCLASGWGSIEPENFSFPDDLQCVDLKILPNDECKKVHVQKVTDFMLCV 200GHLEGGKDTCVGDSGGPLMCDGVLQGVTSWGYVPCGTPNKPSVAVRVLSY 250 VKWIEDTIAENSAgain, amino acids 1 to 18 of SEQ ID NO:1 represent the signal peptide,amino acids 19 to 24 represent propeptide sequences, and amino acids 25to 262 represent the mature peptide. Thus, the preproprotien includes apresumptive 17-amino acid signal peptide, a 7-amino acid proenzymefragment and a 238-amino acid mature KLK1 protein.

A comparison between SEQ ID NO:1 and SEQ ID NO:2 shows two amino aciddifferences between the two hKLK1 amino acid sequences.Single-nucleotide polymorphism (SNP's) between the two individualswithin a species account for an E to Q substitution at amino acidresidue 145 of 262 and an A to V substitution at position 188 of 262.SEQ ID NO:1 has an E (glutamic acid) at position 145 and an A (alanine)at position 188, while SEQ ID NO:2 has a Q (glutamine) at position 145and a V (valine) at position 188.

A KLK1 polypeptide of the present invention may have an E at position145; may have a Q at position 145; may have an A at position 188; mayhave an A at position 188; may have an E at position 145 and an A atposition 188; may have a Q at position 145 and a V at position 188; mayhave an Q at position 145 and an A at position 188; or may have an E atposition 145 and a V at position 188.

In certain embodiments, a tissue kallikrein-1 polypeptide may includeresidues 1-262, residues 19-262, or residues 25-262 of a kallikreinpreproprotein sequence, including, but not limited to human KLK1 havingSEQ ID NO:1 or SEQ ID NO:2, and fragments and variants thereof.

A “variant” of a starting or reference polypeptide is a polypeptide thathas an amino acid sequence different from that of the starting orreference polypeptide. Such variants include, for example, deletionsfrom, insertions into, and/or substitutions of residues within the aminoacid sequence of the polypeptide of interest. A variant amino acid, inthis context, refers to an amino acid different from the amino acid atthe corresponding position in a starting or reference polypeptidesequence. Any combination of deletion, insertion, and substitution maybe made to arrive at the final variant or mutant construct, providedthat the final construct possesses the desired functionalcharacteristics. The amino acid changes also may alterpost-translational processes of the polypeptide, such as changing thenumber or position of glycosylation sites.

A polypeptide variant may have at least about 80%, at least about 85%,at least about 90%, at least about 91%, at least about 92%, at leastabout 93%, at least about 94%, at least about 95%, at least about 96%,at least about 97%, at least about 98%, at least about 98.5%, at leastabout 99%, or at least about 99.5% amino acid identity with a referencesequence, such as, for example, an amino acid sequence described herein.

In some aspects, a KLK1 polypeptide has at least about 80%, at leastabout 85%, at least about 90%, at least about 91%, at least about 92%,at least about 93%, at least about 94%, at least about 95%, at leastabout 96%, at least about 97%, at least about 98%, at least about 98.5%,at least about 99%, or at least about 99.5% amino acid identity to SEQID NO:1, or to a fragment of SEQ ID NO:1, such as for example, residues25-262 or residues 78-141 of SEQ ID NO:1. Such a KLK1 polypeptide mayhave an E or a Q at amino acid residue 145, and/or an A or a Vatposition 188.

In some aspects, a KLK1 polypeptide has at least about 80%, at leastabout 85%, at least about 90%, at least about 91%, at least about 92%,at least about 93%, at least about 94%, at least about 95%, at leastabout 96%, at least about 97%, at least about 98%, at least about 98.5%,at least about 99%, or at least about 99.5% amino acid identity to SEQID NO:2, or to a fragment of SEQ ID NO:2, such as for example, residues25-262 or residues 78-141 of SEQ ID NO:2. Such a KLK1 polypeptide mayhave an E or a Q at amino acid residue 145, and/or an A or a V atposition 188.

“Percent (%) amino acid sequence identity” with respect to a polypeptideis defined as the percentage of amino acid residues in a candidatesequence that are identical with the amino acid residues in thereference sequence, after aligning the sequences and introducing gaps,if necessary, to achieve the maximum percent sequence identity, and notconsidering any conservative substitutions as part of the sequenceidentity. Alignment for purposes of determining percent amino acidsequence identity can be achieved in various ways that are within theskill in the art, for instance, using publicly available computersoftware such as BLAST, BLAST-2, ALIGN, or Megalign (DNASTAR) software.Those skilled in the art can determine appropriate parameters formeasuring alignment, including any algorithms needed to achieve maximalalignment over the full length of the sequences being compared. TheALIGN-2 program is publicly available through Genentech, Inc., South SanFrancisco, Calif.

For purposes herein, the % amino acid sequence identity of a given aminoacid sequence A to, with, or against a given amino acid sequence B(which can alternatively be phrased as a given amino acid sequence Athat has or comprises a certain % amino acid sequence identity to, with,or against a given amino acid sequence B) can be calculated as follows:

100 times the fraction X/Y,

where X is the number of amino acid residues scored as identical matchesby the sequence alignment program in that program's alignment of A andB, and where Y is the total number of amino acid residues in B. It willbe appreciated that where the length of amino acid sequence A is notequal to the length of amino acid sequence B, the % amino acid sequenceidentity of A to B will not equal the % amino acid sequence identity ofB to A.

Variants may also include sequences added to the reference polypeptideto facilitate purification, to improve metabolic half-life or to makethe polypeptide easier to identify, for example, an Fc region, aHis-tag, and/or a PEGylation sequence.

The term “fragment” includes smaller portions of a KLK1 polypeptide thatretain the activity of a KLK1 polypeptide. Fragments includes, forexample, a KLK1 polypeptide fragment that ranges in size from about 20to about 50, about 20 to about 100, about 20 to about 150, about 20 toabout 200, or about 20 to about 250 amino acids in length. In otherembodiments, a KLK1 polypeptide fragment ranges in size from about 50 toabout 100, about 50 to about 150, about 50 to about 200, or about 50 toabout 250 amino acids in length. In other embodiments, a KLK1polypeptide fragment ranges in size from about 100 to about 150, about100 to about 200, about 100 to about 250, about 150 to about 175, about150 to about 200, or about 150 to about 250 amino acids in length. Inother illustrative embodiments, a KLK1 polypeptide fragment ranges insize from about 200 to about 250 amino acids in length. Certainembodiments comprise a polypeptide fragment of a full-length KLK1 ofabout, up to about, or at least about 50, 60, 70, 80, 90, 100, 110, 120,130, 140, 150, 160, 170, 180, 190, 200, 210, 220, 230, 240, 250 or more(e.g., contiguous) amino acid residues. In some embodiments, a fragmentmay have residues 25-262 or residues 78-141 of a preproprotein sequence.In some embodiments, a fragment may be any such fragment size, asdescribed above, of SEQ D NO:1 or SEQ ID NO:2.

A fragments or variant of a KLK1 polypeptide may retain the enzymaticcapacity to release the vasoactive peptide, Lys-bradykinin, from lowmolecular weight kininogen. In some embodiments, an active variant orfragment retains serine protease activity of a KLK1 polypeptide thatreleases kallidin from a higher molecular weight precursor such askininogen, or that cleaves a substrate similar to kininogen such asD-val-leu-arg-7 amido-4-trifluoromethylcoumarin to release acolorimetric or fluorometric fragment.

A “wild type” or “reference” sequence or the sequence of a “wild type”or “reference” protein/polypeptide may be the reference sequence fromwhich variant polypeptides are derived through the introduction ofchanges. In general, the “wild type” amino acid sequence for a givenprotein is the sequence that is most common in nature. Similarly, a“wild type” gene sequence is the polynucleotide sequence for that genewhich is most commonly found in nature. Mutations may be introduced intoa “wild type” gene (and thus the protein it encodes) either throughnatural processes or through human induced means.

In some embodiments of the formulations and methods of the presentinvention, human KLK (hKLK) may be used. One source of KLK1 has beenisolation from pig pancreas. However, such porcine KLK1 preparations mayhave contamination with other porcine proteins, and have been formulatedand administered orally in humans. Additionally, porcine KLK1 has 67%amino acid homology with human KLK1, and administration of procine KLK1into human patients risks eliciting an immune reaction against porcineKLK1.

The KLK1 polypeptides described herein may be prepared by any suitableprocedure known to those of skill in the art, including recombinanttechniques. As one general example, KLK1 may be prepared by a procedureincluding one or more of the steps of: preparing a construct comprisinga polynucleotide sequence that encodes a rhKLK1 and that is operablylinked to a regulatory element; introducing the construct into a hostcell; culturing the host cell to express the rhKLK1; and isolating therhKLK1 from the host cell. The construct and expression system may besuch that the mature or active rhKLK1 is expressed from the host cell.Alternatively, the rhKLK1 may be expressed in an inactive form, such asa propeptide, and the rhKLK1 serine protease activity may be activated(for example, by removing the “pro” sequence) after the rhKLK1 isisolated form the host cell.

In order to express a desired polypeptide, a nucleotide sequenceencoding the polypeptide, or a functional equivalent, may be insertedinto appropriate expression vector, i.e., a vector which contains thenecessary elements for the transcription and translation of the insertedcoding sequence. Methods which are well known to those skilled in theart may be used to construct expression vectors containing sequencesencoding a polypeptide of interest and appropriate transcriptional andtranslational control elements. These methods include in vitrorecombinant DNA techniques, synthetic techniques, and in vivo geneticrecombination. Such techniques are described in Sambrook et al.,Molecular Cloning, A Laboratory Manual (2001), and Ausubel et al.,Current Protocols in Molecular Biology (2003).

A variety of expression vector/host systems are known and may beutilized to contain and express polynucleotide sequences. These include,but are not limited to, microorganisms such as bacteria transformed withrecombinant bacteriophage, plasmid, or cosmid DNA expression vectors;yeast transformed with yeast expression vectors; insect cell systemsinfected with virus expression vectors (e.g., baculovirus); plant cellsystems transformed with virus expression vectors (e.g., cauliflowermosaic virus, CaMV; tobacco mosaic virus, TMV) or with bacterialexpression vectors (e.g., Ti or pBR322 plasmids); or animal cellsystems, including mammalian cell systems. If a non-mammalian cellexpression system is used (such as bacteria) then a process would needto be used to add glycan groups to the rhKLK1, such as geneticallyengineered cells that express the enzymes required for mammalian styleglycosylation.

In mammalian host cells, a number of viral-based expression systems aregenerally available. For example, in cases where an adenovirus is usedas an expression vector, sequences encoding a polypeptide of interestmay be ligated into an adenovirus transcription/translation complexconsisting of the late promoter and tripartite leader sequence.Insertion in a non-essential E1 or E3 region of the viral genome may beused to obtain a viable virus which is capable of expressing thepolypeptide in infected host cells (Logan and Shenk, 1984, PNAS USA;81:3655-3659). In addition, transcription enhancers, such as the Roussarcoma virus (RSV) enhancer, may be used to increase expression inmammalian host cells.

Examples of useful mammalian host cell lines include monkey kidney CV1line transformed by SV40 (COS-7, ATCC CRL 1651); human embryonic kidneyline (293 or 293 cells sub-cloned for growth in suspension culture,Graham et al., 1977, J Gen Virol; 36:59); baby hamster kidney cells(BHK, ATCC CCL 10); mouse sertoli cells (TM4, Mather, 1980, Biol Reprod;23:243-251); monkey kidney cells (CV1 ATCC CCL 70); African green monkeykidney cells (VERO-76, ATCC CRL-1587); human cervical carcinoma cells(HELA, ATCC CCL 2); canine kidney cells (MDCK, ATCC CCL 34); buffalo ratliver cells (BRL 3A, ATCC CRL 1442); human lung cells (W138, ATCC CCL75); human liver cells (Hep G2, HB 8065); mouse mammary tumor (MMT060562, ATCC CCL51); TR1 cells (Mather et al., 1982, Annals NY Acad Sci;383:44-68); MRC 5 cells; FS4 cells; and a human hepatoma line (Hep G2).Other useful mammalian host cell lines include Chinese hamster ovary(CHO) cells, including DHFR-CHO cells (Urlaub et al., 1980, PNAS USA;77:4216)); and myeloma cell lines such as NSO and Sp2/0.

Exogenous DNA of the present invention obtained by genomic or cDNAcloning or by gene synthesis yields recombinant KLK1 (rKLK1)polypeptides. KLK1 polypeptide products of cell culture expression invertebrate (e.g., mammalian and avian) cells may be furthercharacterized by freedom from association with human proteins or othercontaminants, which may be associated with KLK1 in its natural mammaliancellular environment or in extracellular fluids such as plasma or urine.Polypeptides of the invention may also include an initial methionineamino acid residue (at position-1). Certain embodiments thereforeinclude host cells (e.g., eukaryotic host cells such as CHO cells, 293cells) that comprise a recombinant or introduced polynucleotide thatencodes a KLK1 polypeptide described herein, such as the polypeptide ofSEQ ID NO:1 or SEQ ID NO:2. Also included are host cells that comprise apolynucleotide that encodes recombinant (e.g., non-naturally occurring)KLK-1 polypeptide described herein, such as the polypeptide of SEQ IDNO:1 or SEQ ID NO:2.

The cell culture expressed KLK1 polypeptides of the present inventionmay be isolated and purified by using, e.g., chromatographic separationsor immunological separations involving monoclonal and/or polyclonalantibody preparations, or using inhibitors or substrates of serineproteases for affinity chromatography. As will be evident to thoseskilled in the art, the amino acid sequences of SEQ ID NO:1 and SEQ IDNO:2 list the sequence for pre-pro KLK1. If the gene coding for eitherof these sequences is expressed in mammalian cells, the 17-amino acidsignal peptide (residues 1-18) should result in the KLK1 polypeptide tobe secreted by the cell, and the signal peptide removed by the cell. Ifit is desired to not have the polypeptide secreted, or if non-mammaliancells are used for expression, a gene encoding KLK1 may be generated inwhich the signal sequence is omitted or replaced with another sequence.The 7 amino acid pro-sequence (residues 19-24) will inhibit the serineprotease activity of the KLK1 and may be removed to allow activity ofthe mature KLK1 polypeptide. The pro-sequence may be removed after theKLK1 polypeptide is isolated, for example by exposing the pro-KLK1 totrypsin under conditions that will allow cleavage of the pro-sequence,or by generating a gene encoding KLK1 in which the pro-sequence omittedor replaced with another sequence.

In certain aspects, KLK1 polypeptides described herein may be “labeled”by covalent association with a detectable marker substance (such as, forexample, radiolabels such as I¹²⁵ or P³² and nonisotopic labels such asbiotin) to provide reagents useful in detection and quantification ofKLK1 in solid tissue and fluid samples such as blood or urine.

In addition to recombinant production methods, hKLK1 polypeptides may beproduced by direct peptide synthesis using solid-phase techniques (see,for example, Merrifield, 1963, J Am Chem Soc; 85:2149-2154). Proteinsynthesis may be performed using manual techniques or by automation.Automated synthesis may be achieved, for example, using AppliedBiosystems 431A Peptide Synthesizer (Perkin Elmer). Alternatively,various fragments may be chemically synthesized separately and combinedusing chemical methods to produce the desired polypeptide. Also includedis cell-free expression of proteins. These and related embodimentstypically utilize purified RNA polymerase, ribosomes, tRNA andribonucleotides; these reagents may be produced by extraction from cellsor from a cell-based expression system.

The amino acid sequence of tissue kallikrein-1 indicates three potentialAsn-linked (N-linked) glycosylation sites on the polypeptide, at aminoacid positions 78, 84, and 141 (relative to the intact preproproteinamino acid sequence shown, for example, in SEQ ID NO:1), as well asputative O-linked glycosylation sites. For synthesis processes that donot result in glycosylated KLK1 polypeptides, a process may also beemployed to add mammalian style, N-linked glycan groups at positions 78and 84 to generate a double glycosylated glycoform of the KLK1polypeptide or at positions 78, 84 and 141 to generate a tripleglycosylated glycoform of the rhKLK1 polypeptide.

One source of human tissue kallikrein-1 is human urine, also known ashuman urinary KLK1 or HU KLK1. Several companies have isolated HU KLK1,formulated it into a pharmaceutical for administration to human patientsfor treatment of conditions such as cerebral infarction. However,technical challenges have not allowed HU KLK1 to be concentrated. Assuch, because of the dilute concentrations, large volumes of HU KLK1have to be administered to human patients, requiring administration viaintravenous (IV) administration.

Formulations of the present invention may provide advantages overnaturally occurring sources of KLK1, such as urinary KLK1 (e.g., humanKLK1 isolated from human urine). A KLK1 polypeptide as described hereinmay have higher levels of sialic acid compared to urinary KLK1. Suchhigher levels of sialic acid are expected to impart a more negativecharge on the KLK1 protein, and result in a protein with a relativelylow isoelectric point (pI). Such a low pI will result in the rhKLK1protein having a net negative charge at physiological pH (˜pH 7.4). Incontrast, human urinary KLK1 will have a higher pI due to the presenceof fewer sialic acids, and thus will not be as negatively charged atphysiological pH. Protein formulations are ideally near physiological pHas a low or high pH can cause discomfort at the parenteral injectionsite, and/or tissue damage. The low pI of rhKLK1 will also improvesolubility of the protein in a formulation near physiological pH. Thelow pI allows KLK1 to be concentrated without aggregating as thenegative charges at physiological pH would repel and prevent aggregationof rhKLK1. Further, certain compositions comprise a high percentage ofmonomers of rhKLK1, with >95% appearing as a monomer or single peak bySEC HPLC (size exclusion-HPLC).

The glycosylation degree of rhKLK1 described herein mainly relies on thelevel of sialic acid in the carbohydrate chain. As determined bySDS-PAGE electrophoresis, the molecular weight of HU KLK1 is about 39-43kDa. In comparison, the molecular weight of the rhKLK1 described hereinis about 40-49 kDa. The rhKLK1 has a higher and broader electrophoresisband than HU KLK1, indicating its different degree of glycosylation,especially the different degree of sialylation. Therefore, rhKLK1 hasmore complex glycosylation composition than the native protein. Theamount of sialic acid will influence the isoelectric point (pI) of therhKLK1; specifically, increased sialic acid will result in decreased pI.In specific embodiments, the rhKLK1 described herein has a pI of lessthan about 5 and sialic acid content of at least 4 moles per moleprotein. In some aspects, the sialic acid content (mole per mole rhKLK1protein) may be about 4.05, 4.10, 4.15, 4.20, 4.25, 4.30, 4.35 orgreater.

Certain embodiments include KLK1 that has increased sialic acid contentof at least about 4 moles per mole protein and a resulting isolectricpoint of less than about 5 (pI<5), which can be formulated atconcentrations greater than about 5 mg/mL, and which is substantiallyfree of exogenous contaminants such as endotoxin. Such a concentratedrhKLK1 may be administered parenterally and has been shown to produceunexpectedly efficacious results.

Various methods are available to increase the sialic acid content ofrecombinant proteins. Such methods include the addition of certainsugars to the cell culture media, selecting production cell lines thatproduce well sialated proteins, or genetically engineering productioncell lines to express enzymes necessary for silation, for example,CMP-sialic acid transporter (for review, see Bork et al., J Pharm Sci(2009) 98:3499-3508).

Several methods are available to determine sialic acid content includingisoelectric focusing as described herein. Alternate methods forquantifying percent sialylation of glycoproteins include,High-Performance Anion Exchange Chromatography with Pulsed AmperometricDetection (HPAEC-PAD) combined with Matrix Assisted LaserDesorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS)have been used. For quantitative methods, Thiobarbituric Acid Assay(TAA), fluorescence method using o-phenylenediamine-2HCl (OPD) ormalononitrile, derivatization, and enzymatic kits (Sigma, QA Bio, andGlycoscreen™ (ProZyme, San Leandro, Calif.) are some of the methods thatcan be used for quantifying sialic acid content of recombinant proteinsproduced in cell culture.

Purity.

Determinations of the purity of a composition of the present inventionmay include, but are not limited to, determination so endotoxin, hostcell protein, host cell DNA, and/or percentage single peak purity by SECHPLC.

Determination of Host Cell Protein.

Purity may be characterized in relation to the levels of host cellproteins. The host cells used for recombinant expression may range frombacteria and yeast to cell lines derived from mammalian or insectspecies. The cells contain hundreds to thousands of host cell proteins(HCPs) and other biomolecules that could contaminate the final product.The HCP may be secreted along with the protein of interest, or releasedby accidental lysing of the cells, and may contaminate the protein ofinterest. Two types of immunological methods may be applied to HCPanalysis: Western blotting (WB) and immunoassay (IA), which includestechniques such as ELISA and sandwich immunoassay or similar methodsusing radioactive, luminescent, or fluorescent reporting labels.Compositions of the present invention may include host cell protein ofless than about 500, less than about 400, less than about 300, less thanabout 200, less than about 100 or less than about 50 ng/mg totalprotein.

Determination of Host Cell DNA.

Purity can be characterized in relation to the levels of host cell DNA.Detection of residual host cell DNA may be performed by Polymerase ChainReaction (PCR) with a variety of primers for sequences in the host cellgenome. Residual host cell DNA is generally reported as being below acertain threshold level, but may also be quantitated with a rPCR method.Compositions of the present invention may include host celldeoxyribonucleic acid (DNA) of less than about 100, less than about 90,less than about 80, less than about 70, less than about 60, less thanabout 50, less than about 40, less than about 30, less than about 20, orless than about 10 pg/mg total protein.

Endotoxin Testing.

Endotoxin is extremely potent, is heat stable, passes sterilizingmembrane filters and is present everywhere bacteria are or have beenpresent. An Endotoxin Unit (EU) is a unit of biological activity of theUSP Reference Endotoxin

Standard.

The bacterial endotoxins test (BET) is a test to detect or quantifyendotoxins from Gram-negative bacteria using amoebocyte lysate (whiteblood cells) from the horseshoe crab (Limulus polyphemus or Tachypleustridentatus). Limulus amebocyte lysate (LAL) reagent, FDA approved, isused for all USP endotoxin tests. There are three methods for this test:Method A, the gel-clot technique, which is based on gel formation;Method B, the turbidimetric technique, based on the development ofturbidity after cleavage of an endogenous substrate; and Method C, thechromogenic technique, based on the development of color after cleavageof a synthetic peptide-chromogen complex.

Two types of endotoxin tests are described in the USP <85> BET.Photometric tests require a spectrophotometer, endotoxin-specificsoftware and printout capability. The simplest photometric system is ahandheld unit employing a single-use LAL cartridge that contains dried,pre-calibrated reagents; there is no need for liquid reagents orstandards. The FDA-approved unit is marketed under the name ofEndosafe®-PTS™. The device requires about 15 minutes to analyze smallamounts of sample, a 25 μL aliquot from CSP diluted in a sterile tube,and to print out results. In contrast, gel-clot methods require adry-heat block, calibrated pipettes and thermometer, vortex mixer,freeze-dried LAL reagents, LAL Reagent Water (LRW) for hydratingreagents and depyrogenated glassware. In this clot test, diluted sampleand liquid reagents require about an hour for sample andpositive-control preparation and an hour's incubation in a heat block;results are recorded manually. Thus, the simplicity and speed of theautomated system make it ideally suited to the pharmacy setting.

Purity SEC HPLC.

The degree of aggregation of rhKLK1 (isolated glycoform or mixture ofglycoforms) may be determined by Size-exclusion chromatography (SEC),which separates particles on the basis of size. It is a generallyaccepted method for determining the tertiary structure and quaternarystructure of purified proteins. SEC is used primarily for the analysisof large molecules such as proteins or polymers. SEC works by trappingthese smaller molecules in the pores of a particle. The larger moleculessimply pass by the pores as they are too large to enter the pores.Larger molecules therefore flow through the column quicker than smallermolecules, that is, the smaller the molecule, the longer the retentiontime. In certain embodiments, the “purity” of a KLK1 polypeptide in acomposition may be specifically defined. For instance, certaincompositions may include a hKLK1 polypeptide that is at least about 80,at least about 85, at least about 90, at least about 91, at least about92, at least about 93, at least about 94, at least about 95, at leastabout 96, at least about 97, at least about 98, at least about 99, or100% pure, including all decimals in between, as measured, for exampleand by no means limiting, by high pressure liquid chromatography (HPLC),a well-known form of column chromatography used frequently inbiochemistry and analytical chemistry to separate, identify, andquantify compounds. Certain compositions are also substantially free ofaggregates (greater than about 95% appearing as a single peak by SECHPLC). Certain embodiments are free of aggregates with greater thanabout 96%, about 97%, about 98%, or about 99%, appearing as a singlepeak by SEC HPLC.

In certain embodiments, a high concentration KLK1 composition forparenteral administration is substantially pure, as determined by one ormore of the following determinations of purity: less than about 1 EUendotoxin/mg protein, less that about 100 ng host cell protein/mgprotein, less than about 10 pg host cell DNA/mg protein, and/or greaterthan about 95% single peak purity by SEC HPLC.

A high concentration formulation of KLK1 of the present invention may beformulated at a concentration of about 1 to about 200 mg/ml, about 2 toabout 150 mg/ml, about 2.5 to about 100 mg/ml, about 5 to about 75mg/ml, or about 10 to about 50 mg/ml.

In certain instances, the KLK1 is formulated at a concentration of about1 to about 200 mg/ml, about 5 to about 200 mg/ml, about 10 to about 200mg/ml, about 20 to about 200 mg/ml, about 25 to about 200 mg/ml, about50 to about 200 mg/ml, about 75 to about 200 mg/ml, about 100 to about200 mg/ml, about 125 to about 200 mg/ml, or about 150 to about 200mg/ml.

In certain instances, the KLK1 is formulated at a concentration of 1 toabout 100 mg/ml, about 5 to about 100 mg/ml, about 10 to about 100mg/ml, about 20 to about 100 mg/ml, about 25 to about 100 mg/ml, about50 to about 100 mg/ml, or about 75 to about 100 mg/ml.

In some embodiments, the concentration of the KLK1 polypeptide in aformulation of the present invention is greater than about 5 mg/mL,greater than about 10 mg/mL, greater than about 15 mg/mL, greater thanabout 20 mg/mL, greater than about 25 mg/mL, greater than about 50mg/mL; greater than about 75 mg/mL, greater than about 100 mg/mL,greater than about 125 mg/mL, greater than about 150 mg/mL, or greaterthan about 175 mg/mL.

In some embodiments, the concentration of the KLK1 polypeptide in aformulation of the present invention is at least about 5 mg/mL, at leastabout 10 mg/mL, at least about 15 mg/mL, at least about 20 mg/mL, atleast about 25 mg/mL, at least about 50 mg/mL; at least about 75 mg/mL,at least about 100 mg/mL, at least about 125 mg/mL, at least about 150mg/mL, or at least about 175 mg/mL.

In some embodiments, the concentration of the KLK1 polypeptide in aformulation of the present invention is about 5 mg/mL, about 10 mg/mL,about 15 mg/mL, about 20 mg/mL, about 25 mg/mL, about 50 mg/mL; about 75mg/mL, about 100 mg/mL, about 125 mg/mL, about 150 mg/mL, about 175mg/mL, or about 200 mg/mL.

In certain embodiments, the KLK1 polypeptide has a pI of less than about5 and a sialic acid content of at least about 4 moles per mole protein.Also included are compositions formulated for subcutaneousadministration, comprising a recombinant human tissue kallikrein-1(rhKLK1) polypeptide and a pharmaceutically acceptable carrier, wherethe concentration of the rhKLK1 polypeptide in the composition isgreater than about 10 mg/mL, and where the rhKLK1 polypeptide has a pIof less than about 5 and a sialic acid content of at least about 4 molesper mole protein.

Methods for protein concentration. Several methods are known forconcentrating proteins used as pharmaceuticals and may be used for theinstant invention. One method is ultrafiltration, which concentrates aprotein solution using selective permeable membranes. The function ofthe membrane is to let the water and small molecules pass through whileretaining the protein. The solution is forced against the membrane bymechanical pump or gas pressure or centrifugation.

Formulations of KLK1 may be concentrated by lyophilization orfreeze-drying. This process removes all volatile components (e.g., wateror other solvents) leaving the proteins behind. Lyophylization works byfreezing the protein solution and then reducing the surrounding pressureto allow the volatile components (e.g., water or other solvents) in thesolution to sublimate directly from the solid phase to the gas phase.The protein may be partially lyophilized until the desired concentrationis reached, or may be completely lyophilized and then solubilized in asmaller volume. Other methods may also be used, such as capturing theKLK1 on a capture column, and eluting with a small volume.

Drugs are often administered by two general methods, enteral andparenteral administration. Enteral administration involvesadministration by the gastrointestinal tract. Methods of enteraladministration include oral, sublingual (dissolving the drug under thetongue), and rectal. Parenteral administration is administration otherthan through the digestive tract (alimentary canal), but rather by someother route. Parenteral administration may be by injection or infusion.Common injection types are intravenous (into a vein), subcutaneous(under the skin), intramuscular (into muscle), intraperitoneal,intravitreal (intraocular), intracerebral, and intraspinal. Infusionstypically are given by intravenous route. Parenteral dosage forms may besolutions, suspensions, or emulsions, but they must be sterile. The KLK1compositions described herein may be formulated for parenteraladministration by a variety of techniques, including, for example,subcutaneous, intravenous, oral, rectal, transmucosal, transdermal,intestinal, parenteral, intramuscular, intramedullary, intrathecal,direct intraventricular, intraperitoneal, intranasal, and intraocularadministration, among others.

In certain embodiments, the parenteral administration of a KLK1formulation of the present invention demonstrates improved systemicpharmacokinetics. In particular embodiments, the improvedpharmacokinetics comprises increased bioavailability. In someembodiments, the improved pharmacokinetics comprises decreased Tmax. Incertain embodiments, the improved pharmacokinetics comprises increasedCmax. In some embodiments, the improved pharmacokinetics comprisesincreased absorption rate. In certain embodiments, subcutaneouslyadministering the composition produces improved systemicpharmacokinetics relative to intravenously administering thecomposition.

For parenteral administration a high concentration KLK1 composition maybe formulated with pharmaceutically acceptable carriers or excipients,for instance, to optimize stability and achieve isotonicity. In certainaspects, the pH of the formulation may be near physiological pH or aboutpH 7.4, including about pH 6.5, about 7.0, about 7.1, about 7.2, about7.3, about 7.4, about 7.5, about 7.6, about 7.7, about 7.8, about 7.9,about 8.0, about 8.5, or any range thereof. In some embodiments, acomposition (e.g., pharmaceutical composition) comprises a KLK1polypeptide in combination with a physiologically acceptable carrier.Such carriers include pharmaceutically acceptable carriers, excipients,or stabilizers which are nontoxic to the cell or mammal being exposedthereto at the dosages and concentrations employed. Methods offormulation are well known in the art and are disclosed, for example, inRemington: The Science and Practice of Pharmacy, Mack PublishingCompany, Easton, Pa., Edition 21 (2005).

In certain aspects, a formulation of KLK1 may be formulated to deliver adose of a KLK1 of at least about 25 mg, or in the range of about 2 toabout 5000 mg. In some embodiments, the dose may be at least about 0.02to about 5.0 mg/kg/day, at least about 0.02 to about 1 mg/kg/day. Insome embodiments, the dose may be at least about 0.02, about 0.03, about0.04, about 0.05, about 0.06, about 0.07, about 0.08, about 0.09, about0.1, about 0.2, about 0.3, about 0.4, about 0.5, about 0.6, about 0.7,about 0.8, about 0.9, about 1.0, about 1.1, about 1.2, about 1.3, about1.4, about 1.5, about 1.6, about 1.7, about 1.8, about 1.9, about 2.0,about 2.1, about 2.2, about 2.3, about 2.4, about 2.5, about 2.6, about2.7, about 2.8, about 2.9, about 3.0, about 3.1, about 3.2, about 3.3,about 3.4, about 3.5, about 3.6, about 3.7, about 3.8, about 3.9, about4.0, about 4.1, about 4.2, about 4.3, about 4.4, about 4.5, about 4.6,about 4.7, about 4.8, about 4.9, or about 5.0 mg/kg/day.

The phrase “physiologically-acceptable” or “pharmaceutically-acceptable”refers to molecular entities and compositions that do not produce asignificant allergic or similar untoward reaction when administered to ahuman. Typically, such compositions are prepared as injectables, eitheras liquid solutions or suspensions; solid forms suitable for solutionin, or suspension in, liquid prior to injection can also be prepared.The preparations can also be emulsified.

As used herein, “carrier” includes any and all solvents, dispersionmedia, vehicles, coatings, diluents, isotonic and absorption delayingagents, buffers, carrier solutions, suspensions, colloids, and the like.Except insofar as any conventional media or agent is incompatible withthe active ingredient, its use in the therapeutic compositions iscontemplated. Supplementary active ingredients can also be incorporatedinto the compositions.

Subcutaneous injection. A subcutaneous injection (abbreviated as SC, SQ,sub-cu, sub-Q or subcut with SQ being the preferred abbreviation) can beadministered as a bolus into the subcutis, the layer of skin directlybelow the dermis and epidermis, collectively referred to as the cutis.Exemplary places on the body where people can inject SC most easilyinclude, without limitation, the outer area of the upper arm, just aboveand below the waist, excepting in certain aspects the area right aroundthe navel (a ˜2-inch circle), the upper area of the buttock, just behindthe hip bone, and the front of the thigh, midway to the outer side,about 4 inches below the top of the thigh to about 4 inches above theknee. These areas can vary with the size of the person. Also, changingthe injection site can prevent lumps or small dents calledlipodystrophies from forming in the skin.

Subcutaneous injections usually go into the fatty tissue below the skinand in certain instances can utilize a smaller, shorter needle. Inspecific instances, a needle that is about ½ inch to about ⅝ of an inchin length with a gauge of about 25 to about 31 is sufficient tosubcutaneously administer the medication. As will be appreciated bysomeone skilled in the art, these are general recommendations and SCinjections may be administered with needles of other sizes. In someembodiments SC administration is performed by pinching-up on the tissueto prevent injection into the muscle, and/or insertion of the needle ata ˜45° angle to the skin.

Intravenous injection is the injection of hKLK1 into a vein. Theadvantage of intravenous injection is that the hKLK1 is introduced intothe circulation faster than if injected via other routes ofadministration.

Intramuscular injection is injection into the substance of a muscle,usually the muscle of the upper arm, thigh, or buttock. Intramuscularinjections are given when the substance is to be absorbed quickly. Theyshould be given with extreme care, especially in the buttock, becausethe sciatic nerve may be injured or a large blood vessel may be enteredif the injection is not made correctly into the upper, outer quadrant ofthe buttock. The deltoid muscle at the shoulder is also used, but lesscommonly than the gluteus muscle of the buttock; care must be taken toinsert the needle in the center, 2 cm below the acromion. Injectionsinto the anterolateral aspect of the thigh are considered the safestbecause there is less danger of damage to a major blood vessel or nerve.The needle should be long enough to insure that the medication isinjected deep into the muscle tissue. As a general rule, not more than 5ml is given in an intramuscular injection for an adult. The needle isinserted at a 90-degree angle to the skin.

Intraperitoneal injections are not commonly performed in human patientsdue to discomfort, and are administered to obtain systemic blood levelsof the agent; faster than subcutaneous or intramuscular injection andused when veins not accessible. The needle is introduced into the upperflank and the syringe plunger withdrawn to ensure that intestine has notbeen penetrated. The injected solution should run freely.

Intravitreal (intraocular) injections are injections into the eye and asmall volume of injection is essential for these types of injections toavoid hypertension in the eye. The site of injection is usuallyinferotemporal for ease of access. Some Retina Specialists will do theinjection in the superotemporal quadrant, as they feel that should acomplication such as a retinal detachment form, it can be easier treatedwith a pneumatic retinopexy.

Intracerebral injection is an injection into the cerebellum or brain.Such injections would require a small injection volume to avoidlocalized hypertension that may result in damage to neuronal tissue.

Intraspinal (intrathecal) injection is the injection of a substancethrough the theca of the spinal cord into the subarachnoid space.

Dosing. The dosing of rhKLK1 will depend on various factors, includingthe disease to be treated, other medications that the patient is taking,etc. Dosing of rhKLK1 may also depend on the specific activity of therhKLK1 protein. Dosages of rhKLK1 are usually administered based on thenumber of units, which are converted into mg of protein. rhKLK1 is aserine protease which cleaves low-molecular-weight kininogen resultingin the release of kallidin (lys-bradykinin). This activity of KLK1 maybe measured in an enzyme activity assay by measuring either the cleavageof low-molecular-weight kininogen, or the generation of lys-bradykinin.Assays include examples wherein a labelled substrate is reacted withKLK1, and the release of a labelled fragment may be detected. Oneexample of such a fluorogenic substrate suitable for KLK1 measurement ofactivity is D-val-leu-arg-7 amido-4-trifluoromethylcoumarin (D-VLR-AFC,FW 597.6) (Sigma, Cat # V2888 or Ana Spec Inc Cat #24137.) WhenD-VLR-AFC is hydrolyzed, the free AFC produced in the reaction can bequantified by fluorometric detection (excitation 400 nm, emission 505nm) or by spectrophotometric detection at 380 nm (extinctioncoefficient=12,600 at pH 7.2). Other methods and substrates may also beused to measure KLK1 proteolytic activity.

KLK1 activity, measured in Units or Units/ml, may be determined bycomparing the relative activity of a KLK1 sample to the porcinekininogenase standard acquired from the National Institute forBiological Standards and Control (NIBSC Product No. 78/543). For thisstandard, the assigned potency is 22.5 international units (IU) per 20μg ampoule of porcine pancreatic kininogenase. Typically, serialdilutions are made of the standard, and the activity in an unknownsample of KLK1 is compared to the standard. For experiments describedherein, the rhKLK1 glycoforms or mixtures had specific activities ofapproximately 200 to 450 IU/mg, though specific activities of certainlots may be outside this range. However, the specific activity of rhKLK1may vary from lot to lot, and thus would need to be checked to determinethe dosage in mg/kg or total mg of rhKLK1 to administer to an animal orpatient.

According to the FDA Guidance for Industry; Estimating the Maximum SafeStarting Dose in Initial Clinical Trial for Therapeutics in AdultHealthy Volunteers (July 2005), Appendix D: Converting animal doses tohuman equivalent doses. A human equivalent dose is 1/7 the rat dose anda human equivalent dose is 1/12 a mouse dose.

As one non-limiting example, in some aspects, the rhKLK1 polypeptide issubcutaneously administered in an individual dose of at least about 200μg/kg (0.20 mg/kg), or in range of about 20 μg/kg to about 5000 μg/kg(0.02 to 5.0 mg/kg). As one illustrative example, if rhKLK1 isadministered at a dose of about 200 μg/kg into a 90 kg patient, then atotal of about 18.0 mg of rhKLK1 would be required. If the rhKLK1 isformulated at 5 mg/mL, then a total of about 3.6 mL would be injected,which is a large volume and could cause discomfort if injectedsubcutaneously. However, if the rhKLK1 is formulated at 25 mg/mL, thetotal injection volume is 0.72 mL, which is within the recommendedinjection volume for subcutaneous delivery of 1.0 to 1.5 mL.

In particular embodiments a therapeutically effective amount of KLK1includes an amount that lowers fasting glucose in a subject with type 2diabetes or that increases glucose tolerance, or other indicator.Generally, an effective amount of KLK1 administered parenterally perdose includes 5.0 U/kg/day to about 1250 U/kg/day of patient bodyweight, although, as noted above, this is subject to therapeuticdiscretion. As an example, a dose may be 5.0 U/kg/day to 250 U/kg/day,or 5.0 U/kg/day to 150 U/kg/day of patient body weight.

For example, the dose of KLK1 may be increased if a patient's bloodglucose is elevated above a predetermine levels (eg. greater than 180mg/dl or greater than 200 mg/dl) immediately after meal or during a mealtolerance test or an OGTT or the dose is decreased if postabsorptive orfasting blood glucose levels are too low (for example, belowapproximately 80 mg/dl or below approximately 60 mg/dl).

The KLK1 dosage amount can be increased, merely by way of example, byabout 1.1×, 1.2×, 1.3×, 1.4×, 1.5×, 1.6×, 1.7×, 1.8×, 1.9×, 2×, 2.5×,3×, 3.5×, 4×, 4.5×, 5×, 6×, 7×, 8×, 9×, 10×, 15×, 20× or more, relativeto the previous dosage. The dosage frequency can be increased, merely byway of illustration, by about 1, 2, 3, 4, 5 or more dosages per day,and/or 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more dosages per week, relativeto the previous dosing schedule. The dose of KLK1 may also be decreasedby the amounts indicated above, such as a 0.95×, 0.90, 0.85, 0.80, 0.75,0.70, 0.65, 0.60, etc. As noted above, the dosage amount can beincreased or decreased separately or in combination with the dosagefrequency, and vice versa, optionally until a desired level or range ofglucose levels or other treatment indicators are achieved.

Alternatively, to administer a dose of about 500 μg/kg to a 90 kg personequates to about 45 mg of KLK1. If the KLK1 is formulated at 25 mg/mL,the injection volume is about 1.8 mL, which is above the recommendedvolume for subcutaneous injection. If the rhKLK1 is formulated at 50mg/mL, the injection volume is about 0.9 mL or within the tolerablelimit for subcutaneous injection into a human.

The compositions of the present disclosure can be administered by anysuitable means including, but not limited to, for example, oral, rectal,nasal, topical (including, for example, transdermal, aerosol, buccal andsublingual), vaginal, parenteral (including, for example, subcutaneous,intramuscular, intravenous, intradermal, intravesical, intraperitoneal,intravitreal, intraocular, or intracerebral, intraspinal). Somevariation in dosage will necessarily occur depending on the condition ofthe subject being treated. The person responsible for administrationwill, in any event, determine the appropriate dose for the individualsubject. Moreover, for human administration, preparations should meetsterility, pyrogenicity, and general safety and purity standards asrequired by the FDA. Such preparation may be pyrogen-free.

A composition of the present invention may include one or moreadditional therapeutic modalities. In some aspects, the administrationof a composition of the present disclosure may allow for theeffectiveness of a lower dosage of other therapeutic modalities whencompared to the administration of the other therapeutic modalitiesalone, providing relief from the toxicity observed with theadministration of higher doses of the other modalities. One or moreadditional therapeutic agents may be administered before, after, and/orcoincident to the administration of agents of the present disclosure.Agents of the present disclosure and additional therapeutic agents maybe administered separately or as part of a mixture of cocktail. As usedherein, an additional therapeutic agent may include, for example, anagent whose use for the treatment of diabetes is known to the skilledartisan.

A KLK1 composition as described herein may also be administered incombination with other drugs. A KLK1 composition described herein may beused to treat a patient with diabetes such as type 1 diabetes or type 2diabetes and the subject many be administered a KLK composition and aknown diabetes drug, known in the art to be useful in the treatment orprevention of insulin resistance and diabetes. Examples of diabetesdrugs, include, for example, an antioxidant (such as vitamin E, vitaminC, an isoflavone, zinc, selenium, ebselen, or a carotenoid); an insulinor insulin analogue (such as regular insulin, lente insulin, semilenteinsulin, ultralente insulin, detemir, glargine, degludec, NPH orHumalog); an α-adrenergic receptor antagonist (such as prazosin,doxazocin, phenoxybenzamine, terazosin, phentolamine, rauwolscine,yohimbine, tolazoline, tamsulosin, or terazosin); a β-adrenergicreceptor antagonist (such as acebutolol, atenolol, betaxolol,bisoprolol, carteolol, esmolol, metoprolol, nadolol, penbutolol,pindolol, propanolol, timolol, dobutamine hydrochloride, alprenolol,bunolol, bupranolol, carazolol, epanolol, moloprolol, oxprenolol,pamatolol, talinolol, tiprenolol, tolamolol, or toliprolol); anon-selective adrenergic receptor antagonist (such as carvedilol orlabetolol); a first generation sulphonylurea (such as tolazamide,tolubtuamide, chlorpropamide, acetohexamide); a second generationsulphonylurea (such as glyburide, glipizide, and glimepiride); abiguanide agent (such as is metformin); a benzoic acid derivative (suchas replaglinide); a α-glucosidase inhibitor (such as acarbose andmiglitol); a thiazolidinedione (such as rosiglitazone, pioglitazone, ortroglitazone); a phosphodiesterase inhibitor (such as anagrelide,tadalfil, dipyridamole, dyphylline, vardenafil, cilostazol, milrinone,theophylline, or caffeine); a cholineresterase antagonist (such asdonepezil, tacrine, edrophonium, demecarium, pyridostigmine, zanapezil,phospholine, metrifonate, neostigmine, or galathamine); a glutathioneincreasing compound (such as N-acetylcysteine, a cysteine ester,L-2-oxothiazolidine-4-carboxolate (OTC), gamma glutamylcysteine and itsethyl ester, glytathtione ethyl ester, glutathione isopropyl ester,lipoic acid, cysteine, methionine, or S-adenosylmethionine); or incretinor incretin mimetics (such as GLP-1, GLP-2, glucagon like peptideanalogues, such as DAC:GLP-1(CJC-1131), Liraglutide, ZP10, BIM51077,LY315902, LY307161 (SR), and exenatide). In some embodiments, the hKLK1compositions are administered to a subject with insulin or an incretinmimetic.

The present invention includes methods of treating a subject in needthereof, comprising administering to the subject an effective amount ofa composition as described herein. In some embodiments, the subject hasestablished type 1 diabetes (T1D) or type 2 diabetes (T2D). In someembodiments, the subject is in the honeymoon phase, with the recentonset or diagnosis of type 1 diabetes T1D. The honeymoon, or remissionphase, refers to the period following initial diagnosis when theremaining insulin producing beta cells are functioning well. During thishoneymoon, it is easier to control blood sugars, with fewer swings, lessrisk for hypoglycemia, and lower overall average blood-sugar levels. Thehoneymoon period in type I diabetic patients is characterized by thepreserved B cell function. In some embodiments, the subject in thehoneymoon phase or recent onset of T1D has about 10-20% of theirpancreatic beta cells relative to a healthy control and producesinsulin. In some instances, the subject does not have type 1 diabetes(T1D) but is at risk for developing T1D. In some embodiments, thesubject has type 2 diabetes, insulin resistance, pre-diabetes, diabetes,impaired glucose tolerance, impaired glucose metabolism, hyperglycemia,hyperinsulinaemia, and syndrome X. In some embodiments, the subject haslatent autoimmune diabetes of adults (LADA). Type 2 diabetes (T2D) asused herein is a disease characterized by above normal levels of bloodglucose. T2D may be caused by insufficient production of insulin in thesubject or the subject being resistant to the action of insulin (insulinresistant). Administration of the compositions described herein to asubject with T2D may aid in moderating blood glucose levels.

In some embodiments, a therapeutically effective amount of a KLK1composition includes an amount that lowers fasting glucose, increasesglucose tolerance, or other indicator in a subject with diabetes. Insome embodiments, a therapeutically effective dose is the amount of KLK1glycoform composition that treats or delay the onset of type I diabeteswithout adverse side effects on blood pressure and heart rate.

In some embodiments, the subject has an ischemic condition. Non-limitingexamples include cardiac ischemia (myocardial ischemia), ischemiccolitis, brain ischemia (ischemic stroke), limb ischemia, and cutaneousischemia. Also included is traumatic brain injury (TBI). These andrelated medical conditions can be diagnosed according to routinetechniques in the art.

Devices.

The present invention also includes devices that contain a compositiondescribed herein, including devices suitable for parenteral delivery,including, for example, subcutaneous or intravenous delivery. In someembodiments, the device is a syringe. In some embodiments, the syringeis attached to a hypodermic needle assembly, optionally comprising aprotective cover around the needle assembly. In some embodiments, theneedle may be about ½ inch to about ⅝ of an inch in length and has agauge of about 25 to about 31. Certain embodiments thus include devicesthat attached or attachable to a needle assembly that is suitable forsubcutaneous administration, comprising a KLK1 glycoform mixture-basedcomposition described herein. For example, certain devices include avial or syringe, optionally where the vial or syringe is attachable toor is attached to a hypodermic needle assembly. Also included are vialshaving a rubber cap, where a needle/syringe can be inserted into thevial via the rubber cap to withdraw the KLK1-based composition forsubcutaneous administration.

In particular aspects, the device is a syringe that is attachable orattached to a hypodermic needle, and is packaged with one or moreremovable and/or permanent protective covers around the needle or needleassembly. For instance, a first removable protective cover (which isremoved during administration) can protect a user or other person fromthe needle prior to administration, and a second protective cover can beput (i.e., snapped) into place for safe disposal of the device afteradministration.

In certain aspects, a device, optionally a disposable device, comprisesan individual dose of a KLK1 of at least about 25 mg, or in the range ofabout 2 to about 500 mg. In some embodiments, the device comprises adose of at least about 0.02 to about 5.0 mg/kg, at least about 0.02 toabout 10 mg/kg. In some embodiments, the device comprises a dose of atleast about 0.02, about 0.03, about 0.04, about 0.05, about 0.06, about0.07, about 0.08, about 0.09, about 0.1, about 0.2, about 0.3, about0.4, about 0.5, about 0.6, about 0.7, about 0.8, about 0.9, about 1.0,about 1.1, about 1.2, about 1.3, about 1.4, about 1.5, about 1.6, about1.7, about 1.8, about 1.9, about 2.0, about 2.1, about 2.2, about 2.3,about 2.4, about 2.5, about 2.6, about 2.7, about 2.8, about 2.9, about3.0, about 3.1, about 3.2, about 3.3, about 3.4, about 3.5, about 3.6,about 3.7, about 3.8, about 3.9, about 4.0, about 4.1, about 4.2, about4.3, about 4.4, about 4.5, about 4.6, about 4.7, about 4.8, about 4.9,or about 5.0 mg/kg.

In certain aspects, the KLK1 composition may be packaged to allowadministration by the patient or to the patient in a home setting on adaily basis, several times a week, weekly basis, or less frequently. AKLK1 composition may be formulated in a multi-dose vial or amulti-dose/multiuse syringe, similar to formulations of insulin or humangrowth hormone. In a multi-dose vial, an amount sufficient for at least2 administrations may be in a vial (for example, 50 mg, or in the rangeof about 5 to 1000 mg), and a needle and syringe are used to draw therequired amount of KLK1 from the vial and inject into a patient. In amulti-dose or multiuse syringe contains an amount of KLK1 sufficient forat least 2 administrations (for example, 50 mg, or in the range of about5 to 1000 mg), and the volume that may be injected may be determined bythe patient. The multi-dose syringe may also have a replaceablecartridge that may be loaded into the syringe that contains additionalamounts of KLK1 composition.

A composition of the present invention may be endotoxin free orsubstantially endotoxin free. As used herein, the term “endotoxin free”or “substantially endotoxin free” relates generally to compositions,solvents, devices, and/or vessels that contain at most trace amounts(e.g., amounts having no clinically adverse physiological effects to asubject) of endotoxin, and preferably undetectable amounts of endotoxin.Endotoxins are toxins associated with certain bacteria, typicallygram-negative bacteria, although endotoxins may be found ingram-positive bacteria, such as Listeria monocytogenes. The mostprevalent endotoxins are lipopolysaccharides (LPS) orlipo-oligo-saccharides (LOS) found in the outer membrane of variousGram-negative bacteria, and which represent a central pathogenic featurein the ability of these bacteria to cause disease. Small amounts ofendotoxin in humans may produce fever, a lowering of the blood pressure,and activation of inflammation and coagulation, among other adversephysiological effects.

Therefore, in pharmaceutical production, it is often desirable to removemost or all traces of endotoxin from drug products and/or drugcontainers, because even small amounts may cause adverse effects inhumans. A depyrogenation oven may be used for this purpose, astemperatures in excess of 300° C. are typically required to break downmost endotoxins. For instance, based on primary packaging material suchas syringes or vials, the combination of a glass temperature of 250° C.and a holding time of 30 minutes is often sufficient to achieve a 3 logreduction in endotoxin levels. Other methods of removing endotoxins arecontemplated, including, for example, chromatography and filtrationmethods, as described herein and known in the art. Also included aremethods of producing KLK1 polypeptides in and isolating them fromeukaryotic cells such as mammalian cells to reduce, if not eliminate,the risk of endotoxins being present in a composition of the invention.Preferred are methods of producing KLK1 polypeptides in and isolatingthem from recombinant cells grown in chemically defined, serum freemedia.

Endotoxins can be detected using routine techniques known in the art.For example, the Limulus Ameobocyte Lysate assay, which utilizes bloodfrom the horseshoe crab, is a very sensitive assay for detectingpresence of endotoxin. In this test, very low levels of LPS can causedetectable coagulation of the limulus lysate due a powerful enzymaticcascade that amplifies this reaction. Endotoxins can also be quantitatedby enzyme-linked immunosorbent assay (ELISA). To be substantiallyendotoxin free, endotoxin levels may be less than about 0.001, 0.005,0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.08, 0.09, 0.1, 0.5, 1.0, 1.5, 2,2.5, 3, 4, 5, 6, 7, 8, 9, or 10 EU/ml, or EU/mg protein. Typically, 1 nglipopolysaccharide (LPS) corresponds to about 1-10 EU.

The terms “modulating” and “altering” include “increasing,” “enhancing”or “stimulating,” as well as “decreasing” or “reducing,” typically in astatistically significant or a physiologically significant amount ordegree relative to a control. An “increased,” “stimulated” or “enhanced”amount is typically a “statistically significant” amount, and mayinclude an increase that is 1.1, 1.2, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15,20, 30 or more times (e.g., 500, 1000 times) (including all integers anddecimal points in between and above 1, e.g., 1.5, 1.6, 1.7. 1.8, etc.)the amount or level produced by a control composition, sample or testsubject. A “decreased” or “reduced” amount is typically a “statisticallysignificant” amount, and may include a 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%,9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 25%, 30%,35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100%decrease in the amount or level produced a control composition, sampleor test subject. One embodiment, the KLK1 has a decreased Cmax whencomposition of the invention is injected into a subject via asubcutaneous injection compared to intravenous injection. In anotherembodiment of the invention, the KLK1 has an increased Tmax whencomposition of the invention is injected into a subject via asubcutaneous injection compared to intravenous injection. In anotherembodiment of the invention, the KLK1 has an increased half-life or t½when composition of the invention is injected into a subject via asubcutaneous injection compared to intravenous injection. Such decreasedCmax and increased Tmax may be beneficial if KLK1 is injected daily, toallow a slow release of KLK1 into the circulation and avoidance of peakfollowed by trough levels of KLK1.

Other examples of comparisons and “statistically significant” amountsare described herein. A result is typically referred to as“statistically significant” if it is unlikely to have occurred bychance. The significance level of a test or result relates traditionallyto the amount of evidence required to accept that an event is unlikelyto have arisen by chance. In certain cases, statistical significance maybe defined as the probability of making a decision to reject the nullhypothesis when the null hypothesis is actually true (a decision knownas a Type I error, or “false positive determination”). This decision isoften made using the p-value: if the p-value is less than thesignificance level, then the null hypothesis is rejected. The smallerthe p-value, the more significant the result. Bayes factors may also beutilized to determine statistical significance (see Goodman, Ann InternMed. 130:1005-13, 1999).

The term “solubility” refers to the property of a rhKLK1 polypeptideprovided herein to dissolve in a liquid solvent and form a homogeneoussolution. Solubility is typically expressed as a concentration, eitherby mass of solute per unit volume of solvent (g of solute per kg ofsolvent, g per dL (100 mL), mg/ml, etc.), molarity, molality, molefraction or other similar descriptions of concentration. The maximumequilibrium amount of solute that can dissolve per amount of solvent isthe solubility of that solute in that solvent under the specifiedconditions, including temperature, pressure, pH, and the nature of thesolvent. In certain embodiments, solubility is measured at physiologicalpH, or other pH, for example, at pH 6.0, pH 7.0, pH 7.4, pH 8.0 or pH9.0. In certain embodiments, solubility is measured in water or aphysiological buffer such as PBS or NaCl (with or without NaP). Inspecific embodiments, solubility is measured at relatively lower pH (forexample, pH 6.0) and relatively higher salt (for example, 500 mM NaCland 10 mM NaP). In certain embodiments, solubility is measured in abiological fluid (solvent) such as blood or serum. In certainembodiments, the temperature can be about room temperature (for example,about 20, about 21, about 22, about 23, about 24, or about 25° C.) orabout body temperature (37° C.). In certain embodiments, a KLK1polypeptide has a solubility of at least about 1, at least about 2, atleast about 3, at least about 4, at least about 5, at least about 6, atleast about 7, at least about 8, at least about 9, at least about 10, atleast about 11, at least about 12, at least about 13, at least about 14,at least about 15, at least about 16, at least about 17, at least about18, at least about 19, at least about 20, at least about 25, at leastabout 30, at least about 35, at least about 40, at least about 45, atleast about 50, or at least about 60 mg/ml at room temperature or at 37°C.

“Substantially” or “essentially” means nearly totally or completely, forinstance, 95%, 96%, 97%, 98%, 99% or greater of some given quantity.

“Treatment” or “treating,” as used herein, includes any desirable effecton the symptoms or pathology of a disease or condition, and may includeeven minimal changes or improvements in one or more measurable markersof the disease or condition being treated. “Treatment” or “treating”does not necessarily indicate complete eradication or cure of thedisease or condition, or associated symptoms thereof. The subjectreceiving this treatment is any subject in need thereof. Exemplarymarkers of clinical improvement will be apparent to persons skilled inthe art.

A “subject,” as used herein, includes any animal that exhibits asymptom, or is at risk for exhibiting a symptom, which can be treatedwith a KLK1 polypeptide or composition of the present invention.Suitable subjects (patients) include laboratory animals (such as mouse,rat, rabbit, or guinea pig), farm animals, and domestic animals or pets(such as a cat or dog). Non-human primates and, preferably, humanpatients, are included.

By “isolated” is meant material that is substantially or essentiallyfree from components that normally accompany it in its native state. Forexample, an “isolated peptide” or an “isolated polypeptide” and thelike, as used herein, includes the in vitro isolation and/orpurification of a peptide or polypeptide molecule from its naturalcellular environment, and from association with other components of thecell; i.e., it is not significantly associated with in vivo substancessuch as host cell proteins or nucleic acids.

The present invention is illustrated by the following examples. It is tobe understood that the particular examples, materials, amounts, andprocedures are to be interpreted broadly in accordance with the scopeand spirit of the invention as set forth herein.

EXAMPLES Example 1

A cDNA coding for pre-pro-human KLK1, the 262 amino acid residuesequence depicted in SEQ ID NO:2, was purchased from OriGene™(Rockville, Md., USA). The KLK1 cDNA (Catalogue No. SC122623) is a humancDNA open reading frame clone, cloned into the multi-cloning site ofOriGene's pCMV6-XL5 vector, between a cytomegalovirus (CMV) promoter tocontrol transcription of cDNA coding for pre-pro-human KLK1 and apolyadenylation signal. This KLK1 clone was sequenced and, usingtranslation software, translated to reveal SEQ ID NO:2. This sequencediffered at 2 amino acid residues from the human KLK1 sequence inGenBank as Ref No. NP_002248.1 (SEQ ID NO:1). As depicted in SEQ IDNO:2, single nucleotide polymorphisms (SNP's) resulted in an E to Qchange at amino acid residue 145 of 262, and an A to V change at aminoacid position 188 of 262. All subsequent experiments were performed withKLK1 having the amino acid sequence in SEQ ID NO:2.

The human KLK1 cDNA in the pCMV6-XL5 was transfected into a CHO cellline using the FreeStyle™ MAX CHO Expression System (Invitrogen,Carlsbad, Calif. Catalog no. K9000-20). The kit allowed for transienttransfection of vectors into Chinese Hamster Ovary (CHO) cells, growthof the transfected CHO cells in 10 liter culture, and protein expressionin defined, serum-free medium. The CHO cells are grown in suspension andtransient transfection of the KLK1 vector was performed with theliposome reagent supplied in the kit as per instructions.

Expression and purification of recombinant human KLK1 were performedessentially as described by Hsieng S. Lu, et al, (Purification andCharacterization of Human Tissue Prokallikrein and Kallikrein IsoformsExpressed in Chinese Hamster Ovary Cells, Protein Expression andPurification (1996), 8, 227-237). Briefly, following transfection andallowing sufficient time for expression of recombinant human KLK1,culture supernatant from the 10 liter culture of CHO cells was harvestedby centrifugation followed by 0.2 micron filtration. Clarifiedsupernatant was then concentrated, reacted with trypsin to activate therecombinant human KLK1. Because the transient transfection was performedwith the cDNA coding for pre-pro-human KLK1, the recombinant human KLK1secreted from the CHO cells was in an inactive proprotein form.Therefore, activity assay of cell culture supernatant KLK1 involves anactivation step with trypsin digestion. Activation is done with trypsinat 10 nM final concentration for 2 hours at room temperature, and thetrypsin inactivated with Soybean Trypsin Inhibitor (SBTI) (Sigma).

Following activation of the recombinant human KLK1, ammonium sulphatewas added to the supernatant, and it was loaded onto an OCTYL SEPHAROSE®column. The Octyl column elution pool of active KLK1 was furtherpurified by Benzamidine affinity column. Pooled active fractions off theBenzamidine column were then buffer exchanged into DEAE equilibrationbuffer and polished by DEAE column. Active KLK1 fractions from DEAE werepooled and buffer exchanged into 1×PBS buffer. The final KLK1 bulk drugsubstance was aliquoted and stored at −20° C.

Example 2

The purified recombinant human KLK1 contained approximately 30%carbohydrate content based on the molecular weight estimated by sodiumdodecyl sulphate (SDS) polyacrylamide gel electrophoresis (see FIG. 1).KLK1 from CHO cells appears as a band having an apparent molecularweight of ˜40 to 49 kDa; such a broad band may result from differentglycosylation forms of KLK1 secreted by CHO cells. For KLK1 expressed in293 cells, two bands appeared on the SDS-PAGE gel at approximately 40kDa and 45 kDa. The identity of the bands as human KLK1 was confirmed byWestern blot analysis using mouse polyclonal antibody raised against afull-length human KLK1 protein (Catalog # H00003816-B01P, KLK1 purifiedMaxPab mouse polyclonal antibody (B01P), Abnova Corporation, Walnut,Calif., USA) (see FIG. 2). The Western blot confirms the results of theSDS-PAGE gel, in that recombinant human KLK1 from CHO cells appears as aband having an apparent molecular weight of ˜40 to 49 kDa, and KLK1expressed in 293 cells resolves as two bands at approximately 40 kDa and45 kDa.

The purity of rhKLK1 was relatively low endotoxin (<1 EU/mg protein) lowhost cell protein (<100 ng/mg protein), low host cell DNA (<10 pg/mgprotein), and appeared substantially as a monomer (>95% single peak bySEC HPLC).

An enzyme activity assay was used to test for activity of recombinanthuman KLK1 in cell culture supernatants, chromatography fractions duringpurification and in the final purified product. One fluorogenicsubstrate suitable for tissue kallikrein-1 measurement of activity isD-val-leu-arg-7 amido-4-trifluoromethylcoumarin (D-VLR-AFC, FW 597.6)(Sigma, Cat # V2888 or Ana Spec Inc Cat #24137). When D-VLR-AFC ishydrolyzed, the free AFC produced in the reaction can be quantified byfluorometric detection (excitation 400 nm, emission 505 nm according tothe catalogue, but alternate excitation and emissions are possible,including excitation 360 nm, emission 460 nm) or by spectrophotometricdetection at 380 nm (extinction coefficient=12,600 at pH 7.2). Themeasurement of recombinant human KLK1 activity (Units/ml) produced inthe CHO cells was determined by comparing the relative activity ofrecombinant KLK1 to the Kininogenase, Porcine standard acquired from theNational Institute for Biological Standards and Control (NIBSC ProductNo. 78/543). For this standard, the assigned potency is 22.5international units (IU) per 20 μg ampoule of porcine pancreatickininogenase. All dosing of NOD mice was based on units of KLK1.

The rhKLK1 was analyzed by capillary isoelectric focusing (cIEF) toseparate the various glycoforms with varying degrees of sialic acid byisoelectric point or pI. The rhKLK1 was separated by electrophoresis ina pH gradient between the cathode and anode. The rhKLK1 migrates throughthe gradient until its net charge is zero thus resulting in itsisoelectric point (pI). Markers were used to indicate pI values of 5.12and 3.21. The cIEF analysis method was conducted on an iCE280 cIEFanalyzer equipped with a PrinCE microinjector. Two samples of rhKLK1produced as described herein were analyzed, and the results are shown inFIG. 3 and summarized in Table 1 below. Twelve peaks were detected withpI's ranging from 4.81 to 3.30 (peak 1 is the marker pI 3.21).

TABLE 1 Capillary Isoelectric Focusing Peak Peak Peak Peak Peak PeakPeak Peak Peak Peak Peak Peak Peak 1 2 3 4 5 6 7 8 9 10 11 12 13 1 3.313.42 3.52 3.64 3.78 3.89 4.04 4.22 4.37 4.56 4.72 4.81 2 3.30 3.42 3.523.64 3.78 3.89 4.05 4.22 4.37 4.56 4.72 4.80

To quantitate the sialic acid content, the rhKLK1 samples were analyzedby High Performance Anion Exchange Chromatography with PulseAmperometric Detection (HPAEC-PAD). This method was accomplished by mildacid hydrolysis to release sialic acids from rhKLK1 followed byHPAEC-PAD to separate and quantify the recovered sialic acids. TheHPAEC-PAD identifies the monosaccharides by comparing the retention timeand electrochemical responses of monosaccharides released from rhKLK1with those of standards of known concentrations. The result was 4.15moles of sialic acid were detected per mole of protein.

Example 3

Generation of concentrated formulation of rhKLK1. The following exampledetermined that rhKLK1 could be concentrated to at least 50 mg/mL, andthat the resulting high concentration formulation would be stable andnot aggregate.

The rhKLK1 having at least 4 moles sialic acid per mole protein wasformulated into formulations having 5 mg/mL, 10 mg/mL, 25 mg/mL and 50mg/mL. Bulk rhKLK1 was concentrated using VIVASPIN® 500 CentrifugalConcentrator 3,000 MWCO PES membrane. The protein concentration ofrhKLK1 was determined by absorbance at 280 nm and the samples were closeto the target concentration (5.0 mg/mL, 9.9 mg/mL, 26.2 mg/mL and 50.3mg/mL). Following concentration, the samples were sterile filteredthrough a 0.2 μm filter. The rhKLK1 samples at the four differentconcentrations were filled into Schott borosilicate 3 cc, 13 mm serumvials at a fill volume of 0.5 mL, and the vials were sealed with a Daiko13 mm injection stopper, Flourotec Plus, B2-40 rubber stopper. Thesamples were stored at 2-8° C. and tested for aggregation via SEC HPLCon day 0 and day 7.

SEC HPLC was performed with a column TSKgel SW3000×L, 7.8 mm ID×30 cm, 5μm particles (part #08541, column # T01819-175) and guard column: TSKgelguard SWxL, 60 mm ID×4.0 cm, 7 μm particles (part #08543, lot # T00281).The mobile phase was 10 mM sodium phosphate, 350 mM NaCl, pH 7.4, flowrate at 1.0 mL/min and detector set at 214 nm. Time=20 min and load=30μg (30 μL at 1 mg/mL).

On day 0, all formulation appeared clear and free of visibleparticulates. On day 0, the SEC HPLC analysis of the four rhKLK1formulations at different concentrations all revealed a single peakindicating there was no aggregation of rhKLK1 at any of the fourconcentrations tested. Analysis of the single peak and specificallycalculation of the total area revealed the main single peak accountedfor 100% of the rhKLK1 protein as monomers (see Table 2).

TABLE 2 SEC HPLC T = Day 0 Sample % Main Peak Total Area Interim Ref.Std. (n = 3) 100.0 40051.8 rhKLK1 5 mg/mL 100.0 40720.5 rhKLK1 10 mg/mL100.0 39805.5 rhKLK1 25 mg/mL 100.0 42366.5 rhKLK1 50 mg/mL 100.041433.5

The four formulations were stored at 2-8° C. for 7 days. On day 7, theconcentrations of rhKLK1 were determined in the samples. Allformulations remain close to their target concentration and nosignificant differences were observed between formulations. All fourformulations appeared clear and free of visible particulates on day 7.SEC HPLC analysis revealed a single peak (see FIGS. 4A and 4B). Analysisof the single peak and specifically calculation of the total arearevealed the main single peak accounted for 100% of the rhKLK1 proteinas monomers (see Table 3).

TABLE 3 SEC HPLC T = Day 7 Sample % Main Peak Total Area Interim Ref.Std. (n = 3) 100.0 40445.3 rhKLK1 5 mg/mL 100.0 40534.0 rhKLK1 10 mg/mL100.0 40651.0 rhKLK1 25 mg/mL 100.0 42280.0 rhKLK1 50 mg/mL 100.042453.3

No significant differences were observed between formulations at day 7as compared to time zero. No degradation of rhKLK1 observed after 7 daysof storage at 2-8° C. Therefore, the rhKLK1 could be formulated at highconcentrations (up to 50 mg/mL) and remain stable with no aggregation orother degradation.

Example 4

This example compared the pharmacokinetics and activity of recombinanthuman tissue kallikrein-1 (rhKLK1) when given by intravenous bolus andsubcutaneous injection as a single dose to male Sprague Dawley rats.

TABLE 4 Experimental Design Dose Dose Dose No. of Test Level Concen-Volume Grp Animals^(a) Material/ (mg/kg/ tration (mL/kg/ No. Male Routedose) (mg/mL) dose) 1 12 rhKLK1/SC 0.01049 0.00525 2 (5 U/kg) 2 12rhKLK1/SC 0.1049 0.0525 2 (50 U/kg) 3 12 rhKLK1/IV 0.01049 0.00525 2 (5U/kg) 4 12 rhKLK1/IV 0.1049 0.0525 2 (50 U/kg) ^(a)Animals wereeuthanized on Day 3 after final study sample collections.

Animals. The Sprague-Dawley rat was chosen for this study as it is aspecies that has shown pharmacologic responses to rhKLK1, and is aspecies that is commonly used for nonclinical toxicity evaluations. Thetotal number of animals used in this study (as well as the group sizeand number of groups) was considered to be the minimum required toproperly characterize the pharmacokinetic properties of rhKLK1.

Male Sprague Dawley CRL:CD®IGS rats, approximately 8 weeks of age werepurchase from Charles River Laboratories, Hollister, Calif. The ratswere allowed to acclimate to the laboratory environment for a minimum of7 days prior to the first day of dosing. Food (LABDIET® Certified CR 14%Protein Rodent Diet 5CR4) and water was provided ad libitum throughoutthe study. Each animal was identified by a cage label, tail marking,and/or radio frequency identification transponders. Animals wereassigned to groups by a stratified randomization scheme designed toachieve similar group mean body weights. The animals were approximately9 weeks of age at the time of initiation of dosing with body weightsranging from 252.2 to 310.1 grams.

The rhKLK1 was provided at a concentration of 1.28 mg/mL (610 U/mL or476.56 U/mg), was diluted with PBS on Day 1 to yield dosing formulationat appropriate concentrations (0.00525 mg/mL and 0.0525 mg/mL). At thisconcentration, the rhKLK1 may be administered at 2 mL/kg/dose to achievethe final dose level.

Administration of rhKLK1 and vehicle control. The rhKLK1 wasadministered to animals in Groups 1 and 2 by subcutaneous injection onceon Day 1. The dose volume for each animal was based on the most recentbody weight measurement. The animal's back was clipped free of hairprior to the first dose. The animals were temporarily restrained fordose administration, and were not sedated. The volume for each dose wasadministered in one separate injection within the demarcated area.

The rhKLK1 was administered to animals in Groups 3 and 4 via intravenous(slow bolus) injection into a lateral tail vein once on Day 1. The dosevolume for each animal was based on the most recent body weightmeasurement. The animals were temporarily restrained for doseadministration, and were not sedated. Disposable sterile syringes wereused for each animal/dose.

Clinical Observations. The following parameters and end points wereevaluated in this study: clinical signs (mortality/moribundity checksand detailed clinical observations), body weights, body weight changes,food consumption, and bioanalytical and pharmacokinetic parameters.General health/mortality and moribundity checks were performed twicedaily, in the morning and afternoon.

Results of clinical observations. Administration of rhKLK1 by singleintravenous bolus or subcutaneous injection was well tolerated in maleSprague-Dawley rats at levels of 0.0149 or 0.1049 mg/kg. NorhKLK1-related effects were observed during the study period inmortality/moribundity, detailed clinical observations, body weights,body weight changes and food consumption.

Bioanalysis and Pharmacokinetic Evaluation Sample Collection. Blood wascollected from the jugular (preferred) or lateral tail vein. Animalswere not fasted for sample collections. Samples were collected at thefollowing times after administration of rhKLK1: 5 min, 15 min, 30 min, 1hr, 2, 4, 8, 12, 24, 48 and 72 hours. Blood samples were processed forplasma and were kept in a freezer set to maintain −80° C. Plasma sampleswere analyzed for concentration of test article. Several ELISA methodsare known for detecting human KLK1 in serum or plasma and may be used.For example, a sandwich EILSA is described in WO/2004/029238 whereinrabbit anti-human KLK1 polyclonal immune globulin is coated onto aplate, and used to capture human KLK1. Here, the captured human KLK1 maybe detected using labeled rabbit anti-human KLK1 polyclonal immuneglobulin. The capture and detection steps may also be performed withmonoclonal antibodies, or a combination of polyclonal and monoclonalantibodies. For example, a monoclonal antibody that binds human KLK1 maybe used to capture the human KLK1, and labeled polyclonal antibody todetect KLK1.

Pharmacokinetic Evaluation. Pharmacokinetic parameters were estimatedusing WInNONLIN® pharmacokinetic software (Pharsight Corp., MountainView, Calif.). A non-compartmental approach consistent with thesubcutaneous and IV routes of administration was used for parameterestimation. All parameters were generated from mean rhKLK1concentrations in plasma from Day 1 unless otherwise stated. Meanconcentrations were derived from 3 animals/group/time point/PK samplingoccasion. Parameters were estimated using sampling times relative to thestart of each dose administration.

The following pharmacokinetic parameters were estimated: C_(max)—themaximum observed arithmetic mean concentration of rhKLK1 measured afterdosing; C_(max)/D—the C_(max) divided by the dose administered;T_(max)—the time after dosing at which the maximum observed arithmeticmean concentration of rhKLK1 was observed; AUC(0-t)—the area under therhKLK1 arithmetic mean concentration versus time curve from time zerothe time after dosing at which the last quantifiable concentration ofthe drug was observed estimated by the linear or linear/log trapezoidalmethod; and AUC(0-t)/D—the AUC(0-t) divided by the dose administered.

When data permitted, the slope of the terminal elimination phase of eacharithmetic mean concentration versus time curve was determined bylog-linear regression, and the following additional parameters were alsoestimated.

In some instances, the following additional parameters were alsomeasured: T_(1/2)—the apparent terminal elimination half life;AUC(0-inf)—the area under the arithmetic mean concentration versus timecurve from time zero to infinity; AUC(0-inf)/D—the AUC(0-inf) divided bythe dose administered; CL—the clearance, or the apparent volume ofplasma cleared of rhKLK1 per unit time following intravenous dosing; andVd—the apparent volume of distribution of rhKLK1, determined from theterminal elimination phase following intravenous dosing.

Bioanalysis and Pharmacokinetic Evaluations. Based on the ELISA totalantigen testing, rhKLK1 was detected in plasma samples from the SC0.1049 mg/kg/dose, IV 0.01049 mg/kg/dose, and IV 0.1049 mg/kg/dosegroups. No measurable amount of rhKLK1 was detected in the 0.01049 mg/kgSC dosed group (rhKLK1 levels were below the level of detection for thisELISA).

For the subcutaneous 0.1049 mg/kg dose, the peak rhKLK1 mean plasmaconcentration (based on total antigen) was observed at 12 hours followedby a shallow monoexponential decline where the terminal eliminationphase was not reached. For intravenous administration, the T_(max) wasobserved at 15 min for the 0.01049 mg/kg dose and 5 min for 0.1049 mg/kgdose. Limited exposure did not allow for characterization of theterminal phase at 0.01049 mg/kg by intravenous administration. For theintravenous 0.1049 mg/kg dose, the peak KLK1 plasma concentration wasfollowed by a monoexponential decline and T1/2 was estimated to be about6.44 hours. Volume of distribution (Vd) and clearance (CL) were 225mL/kg and 24.2 mL/h/kg, respectively for the IV dose of 0.1049 mg/kg.Absolute bioavailability (SC/IV) was 583% for the 0.1049 mg/kg doselevel. Because the rhKLK1 levels in rats injected SC did not decreasesufficiently from the peak levels within the 72 hrs, the T1/2 for SCinjection could not be accurately calculated. However, it appears theT1/2 for rhKLK1 in rats following SC injection is greater than 24 hours.

The pharmacokinetic parameters of rhKLK1 in Male Sprague-Dawley ratplasma following subcutaneous injection of rhKLK1 (0.1049 mg/kg/dose)and intravenous bolus injection of rhKLK1 (0.01049 and 0.1049mg/kg/dose) are summarized in Table 5 below.

TABLE 5 Pharmacokinetic Parameters of rhKLK1 Dose Level (mg/kg/dose)SubQ 0.1049 IV 0.01049 IV 0.1049 T_(max) (hrs) 12 0.25 0.083 C_(max) +/−507 +/− 143 57.4 +/− 35.4 960 +/− 182 SE (ng/mL) AUC(0-t) +/− 23185 +/−1598  21.9 +/− 8.35 3979 +/− 361  SE (ng · h/mL) AUC(0-inf) NE  4328 (ng· h/mL) T_(1/2) (hrs) >24 NE 6.44 V_(d) NE 225 (mL/kg)  CL NE 24.2(mL/h/kg) C_(max)/Dose 4830 5474 9148 AUC(0-t)/ 221016 2086 37936 DoseAUC(0-inf)/ — 41260 Dose

The absolute bioavailability of rhKLK1 in Male Sprague-Dawley rat plasmafollowing subcutaneous or intravenous bolus injection of rhKLK1 is shownin FIG. 4A (subcutaneous) and FIG. 5B (intravenous) was calculated to be53% based on Cmax and 583% based on AUC. The following formula was usedto calculate Bioavailability for the 0.1049 mg/kg dose level of rhKLK1based on AUC:

Fa(%)={AUC(SC)/Dose(SC)}/{AUC(IV)/Dose(IV)}×100

=221016/37936×100

Fa(%)=583

By definition, when a medication is administered intravenously, itsbioavailability is 100%. However, when a medication is administered viaother routes (such as subcutaneously), its bioavailability generallydecreases. This is especially true for protein pharmaceuticals, wherefollowing subcutaneous administration some protein may be degraded whilebeing absorbed into the circulation

The data in FIGS. 5A and 5B surprisingly show improved bioavailabity ofrhKLK1 following subcutaneous administration relative to intravenousadministration. For instance, at comparable dosages (0.1049 mg/kg/dose),these data show a slower yet relatively sustained increase in peakbioavailability of rhKLK1 during the first 12 hours post-subcutaneousadministration, followed by a relatively slow decrease in rhKLK1 levelsover then next 72 hours, compared to faster increase in peakbioavailability of rhKLK1 almost immediately post-intravenousadministration, followed by a faster drop in rhKLK1 levels over the next24 hours.

In a follow-on experiment, rhKLK1 was administered subcutaneously intoSprague Dawley rats at a very high dose (3.69 mg/kg) to measure thetoxicokinetics. Male and female Sprague Dawley CRL:CD®IGS rats werereceived from Charles River Laboratories, Hollister, Calif. The animalswere allowed to acclimatize for 5 days, and were provided LABDIET®Certified CR 14% Protein Rodent Diet 5CR4 and water ad libitum. A totalof 6 male and 6 female rats were dosed with rhKLK1 at 3.69 mg/kg (1000U/kg). The weight of the animals was between 377.6 to 421.1 g for themales and 217.2 to 248.0 g for the females.

The following parameters and end points were evaluated in this study:clinical signs (mortality/moribundity checks and detailed clinicalobservations), body weight changes, food consumption, clinical pathologyparameters (hematology, coagulation, clinical chemistry, andurinalysis), toxicokinetic and anti-therapeutic antibody parameters,gross necropsy findings, organ weights, and histopathologicexaminations.

There were no observed toxicity effects of rhKLK1 when given bysubcutaneous (SC) injection once with a dose of 3.69 mg/kg and observeddaily for 14 days. There were no rhKLK1 related organ weight changes,gross observations at necropsy, or microscopic findings on Day 15 in theanimals in the tissues examined (subcutaneous injection site, brain,heart, kidney, liver, lung, pancreas, spleen and any grosslesions/masses).

Blood samples were drawn from the rats at 0 hr, 1 hr, 2 hr, 4 hr, 8 hr,12 hr and 24 hr post injection. Blood samples were processed for plasmawhich was stored at −80° C. Plasma was analyzed for rhKLK1 levels byELISA. The results are depicted graphically in FIG. 6 and specificparameters are tabulated in Table 6 below.

TABLE 6 Toxicokinetic parameters of rhKLK1 in rat plasma followingsubcutaneous injection Cmax +/− AUC (0-t) +/− Tmax SE SE AUC (0-24) (h)(ng/mL) ng · h · mL ng · h/mL T½ Males 24 524 +/− 39.8 10163 +/− 52610163 NE Females 12 596 +/− 51   11543 +/− 624 11543 NE

No measurable amount of rhKLK1 was detected at time 0 as expected. Allanimals had detectable rhKLK1 concentrations in plasma post dose, andthe levels were sustained until 24 hours postdose for the females andmales. The terminal elimination phase and T ½ could not be characterizedfor males or females due to sustained peak concentrations. However, theT½ is greater than 24 hours. No gender differences in the Cmax and AUCvalues were observed.

Dosing rats at 3.69 mg/kg of rhKLK1 SC generated similar results todosing at 0.1049 mg/kg, providing sustained rhKLK1 levels and improvedsystemic pharmacokinetics relative to intravenously administering thecomposition.

Example 5 Pharmacokinetics in Cynomolgus Monkeys

The pharmacokinetics of rhKLK1 in was characterized in male and femalecynomolgus monkeys (2 males and 2 females) following subcutaneousinjection at 1.80 mg/kg/day for 14 days. The Cmax of rhKLK1 was reachedat 2 hours post-dose for the females and generally by 4 hours for themales. This gender difference in reaching Cmax is likely due to thesmall sample size and is unlikely to be detected in larger sample sizes.

Example 6 Toxicology Studies in Rats and Monkeys

A dose range-finding study was conducted in Sprague Dawley rats todetermine the potential toxicity of rhKLK1 when given by single SCinjection in a dose escalation study. Rats (N=3 males and 3 females perdose group) received single SC injections of 0.74 mg/kg, 1.85 mg/kg and3.69 mg/kg. The following parameters and end points were evaluated inthis study: clinical signs (mortality/moribundity checks and detailedclinical observations), body weight changes, food consumption, clinicalpathology parameters (hematology, coagulation, clinical chemistry, andurinalysis), gross necropsy findings, organ weights, and histopathologicexaminations. There were no observed toxicity effects of rhKLK1 whengiven by subcutaneous injection once during an escalating dose at a doserange of 0.74, 1.85 and 3.69 mg/kg.

An exploratory dose range-finding study was conducted in cynomolgusmonkeys following single escalating subcutaneous injections of rhKLK1 todetermine the potential toxicity of rhKLK1. Monkeys (one male and onefemale per dose group) were administered 0, 0.72 mg/kg and 1.80 mg/kg.The following parameters and end points were evaluated in this study:clinical signs, injection site observations, body weights, foodconsumption, clinical pathology parameters (hematology, coagulation,clinical chemistry, and urinalysis), blood pressure (via implantabletelemetry), gross necropsy findings, organ weights, and histopathologicexaminations. There were no observed toxicity effects of rhKLK1 whengiven by subcutaneous injection once during an escalating dose at a doserange of 0.72 and 1.80 mg/kg.

Although the foregoing invention has been described in some detail byway of illustration and example for purposes of clarity ofunderstanding, it will be readily apparent to one of ordinary skill inthe art in light of the teachings of this invention that certain changesand modifications may be made thereto without departing from the spiritor scope of the appended claims.

The complete disclosure of all patents, patent applications, andpublications, and electronically available material (including, forinstance, nucleotide sequence submissions in, e.g., GenBank and RefSeq,and amino acid sequence submissions in, e.g., SwissProt, PIR, PRF, PDB,and translations from annotated coding regions in GenBank and RefSeq)cited herein are incorporated by reference. In the event that anyinconsistency exists between the disclosure of the present applicationand the disclosure(s) of any document incorporated herein by reference,the disclosure of the present application shall govern. The foregoingdetailed description and examples have been given for clarity ofunderstanding only. No unnecessary limitations are to be understoodtherefrom. The invention is not limited to the exact details shown anddescribed, for variations obvious to one skilled in the art will beincluded within the invention defined by the claims.

SEQUENCE LISTING FREE TEXT

SEQ ID NO:1-2 Amino acid sequences of human tissue kallikrein-1preproprotein

What is claimed is:
 1. A composition formulated for parenteraladministration, the composition comprising a human tissue kallikrein-1(hKLK1) polypeptide and a pharmaceutically acceptable carrier, whereinthe concentration of the hKLK1 polypeptide in the composition is greaterthan about 5 mg/mL.
 2. The composition of claim 1, wherein the hKLK1polypeptide has a pI of less than about 5 and a sialic acid content ofat least about 4 moles per mole protein.
 3. The composition of claim 1,wherein the hKLK1 concentration is greater than about 10 mg/mL.
 4. Thecomposition of claim 1, wherein the hKLK1 concentration is greater thanabout 25 mg/mL.
 5. The composition of claim 1, wherein the compositionis substantially free of aggregates (greater than about 95% appearing asa single peak by SEC HPLC).
 6. The composition of claim 1, wherein thecomposition has endotoxin levels of less than about 1 EU/mg protein,host cell protein of less than about 100 ng/mg protein, and host cellDNA of less than about 10 pg/mg protein.
 7. The composition of claim 1,where the hKLK1 comprises an amino acid sequence with at least about 95%sequence identity to residues 25-262 of SEQ ID NO:1 or SEQ ID NO:2 andhas serine protease activity.
 8. The composition of claim 7, where theserine protease activity is characterized by the ability to releasekallidin from a higher molecular weight precursor.
 9. The composition ofclaim 7, where the hKLK1 polypeptide comprises E145 and/or A188,relative to SEQ ID NO:1.
 10. The composition of claim 7, where the hKLK1polypeptide comprises Q145 and/or V188, relative to SEQ ID NO:1.
 11. Thecomposition of claim 1, where the hKLK1 polypeptide comprises ofresidues 25-262 of SEQ ID NO:2.
 12. The composition of claim 1, wherethe hKLK1 polypeptide consists of residues 25-262 of SEQ ID NO:2.
 13. Amethod of treating a subject in need thereof, the method comprisingparenterally administering to the subject a composition of claim 1 andthereby treating the subject.
 14. The method of claim 13, where thecomposition is administered subcutaneously.
 15. The method of claim 13,where the composition is administered intravenously.
 16. The method ofclaim 14 where administering the composition subcutaneously producesimproved systemic pharmacokinetics relative to intravenouslyadministration of the composition.
 17. The method of claim 16, where theimproved pharmacokinetics comprises increased apparent half-life. 18.The method of claim 16, wherein the improved pharmacokinetics comprisesdecreased Tmax.
 19. The method of claim 16, where the improvedpharmacokinetics comprises increased Cmax.
 20. The method of claim 16,where the improved pharmacokinetics comprises increased absorption rate.21. A device comprising a composition of claim 1, wherein the device issuitable for parenteral delivery of the composition.